"I am 68 years old and have a pace maker. I suffer with infrequent bouts of Atrial Fibrillation. It's managed with medications. I want to try cannabis for chronic pain. Should I be worried about my heart?"
Cannabis consumption in a systemic form such as smoking has been associated with heart palpitations and fast heart rhythms. Smoked cannabis should likely be avoided in your case for this reason. Some studies suggest the negative cardiovascular effects of smoked cannabis are related to THC. There has not been enough research on CBD extract products to determine if they are safe for those with atrial fibrillation. There have not been any studies associating localized forms of cannabis with harmful heart rhythms. It is likely safe, from a cardiovascular standpoint, to use topical cannabis infused patches, balms, salves, massage oils, etc. in limited quantities for localized pain control.
You should discuss your particular case closely with your cardiologist and cannabis-recommending physician before use.
A growing number of case reports have demonstrated an association between smoked cannabis consumption and adverse cardiacvascular effects. This includes cardiac dysrythmia including atrial fibrillation and increased cardiac work, which can precipitate cardiac chest pain and even heart attacks. Smoked cannabis has also been associated with low blood pressure upon standing which can increase the risk of fainting. These effects are likely mediated by an effect in which THC triggers the sympathetic nervous system in intermittent users. Chronic users appear to develop tolerance to triggering of the sympathetic nervous system; however, they may suffer from microscopic damage to the arteries that supply the heart.
Interestingly, a recent large case-control study from Denmark demonstrated that NSAID type medications (Ibuprofen/Advil and Naproxen/Aleve etc) are also associated with increased incidence of atrial fibrillation. This is in addition to prior literature that shows NSAIDs can aggravate hypertension. A series of two studies published in 2015 additionally show that opiates are likely associated with a higher risk of heart attack and atrial fibrillation. Unfortunately, there is no ideal option for chronic pain control in the setting of atrial fibrillation.
References: Korantzopoulos P. Atrial fibrillation and Marijuana Smoking. Int J Clin Pract. 2008;62(2):308-313 Jones RT. Cardiovascular system effects of marijuana. J Clin Pharmacol 2002; 42 (11 Suppl.): 58S-63. Sidney S. Cardiovascular consequences of marijuana use. J Clin Pharmacol 2002; 42 (11 Suppl.): 64S-70. Rezkalla SH, Sharma P, Kloner RA. Coronary no-flow and ventricular tachycardia associated with habitual marijuana use. Ann Emerg Med 2003; 42: 365-9
I like Dr. Sank's response and agree but I wanted to add some information that may be of benefit to you. Do you know your blood level of vitamin D? Optimizing your vitamin D level reduces the risk of heart disease as well as many other devastating diseases in the body. You must maintain your 25-OH D, blood level above 50 ng/ML for optimum health benefits including reducing your risk of heart disease, hypertension, auto immune disease, infections, mental health conditions and even cancer. Vitamin D deficiency is rampant in our culture because everyone is working inside, we wear clothes, sunscreen and we shower frequently washing the vitamin D off our skin before we have a chance to absorb it. I tested my patients in Hawaii for 10 years and found one patient with a normal vitamin D3 level! Why would Hawaii be so low in vitamin D? Because everyone showers before they leave the beach and most are very brown skin so they block the production of vitamin D. Another substance that has a lot to do with your heart function is your own human growth hormone. I'm not advocating you inject yourself with human growth hormone since it costs about $1000 a month and it takes over control of your ability to make your own human growth hormone but when your level is too low you will experience all the diseases of an aged person including heart disease which you already have. Now add to the vitamin D and human growth hormone problems the fact that you are probably hormone deficient at 68 years old. My hormones took a precipitous decline after the age of 60 and I felt like I was dying by the time I was 63 years old but I have fully restored my health by addressing all these issues. I don't know if you are male or female so I can't go into detail about what hormones you should take but when we lose our sex hormones the universe is ready to recycle us. If you're not ready for the recycle bin you may want help with natural hormones and I might be the person to see. I came back from the brink of death because I wasn't ready to be recycled and I want you to know that if you are alive, you can likely improve your health tremendously. Do not accept the negativity of most Western physicians. Good luck in your journey.
Yes that is my user name.